PURPOSE: To investigate the feasibility and diagnostic value of a whole prostate qualitative approach to combined magnetic resonance imaging and spectroscopy (MRI+MRS) in the detection of prostate cancer in patients with elevated PSA. MATERIALS AND METHODS: Three hundred and fifty six subjects (mean serum PSA 11.47ng/ml, range 0.40-133ng/ml) were examined with fast-T2-weighted images (MRI) and 3D-magnetic resonance spectroscopy (MRS). Both modalities were qualitatively analyzed on a whole prostate basis by a single radiologist using a 4-point diagnostic scale. Prostate cancer was histopathologically proven in 220 patients and non-evidence of cancer was determined after at least 12 months clinical follow-up in 136 subjects. RESULTS: Receiver operating curve analysis revealed a significantly better diagnostic performance of MRI+MRS (A(z)=0.857) than MRI alone (A(z)=0.801) and MRS alone (A(z)=0.810). The sensitivity, specificity and accuracy of MRI+MRS for detection of prostate cancer were 72.3%, 92.6%, and 80.1%, respectively. CONCLUSIONS: Spectral evaluation with a whole prostate qualitative approach is feasible in routine clinical practice. The combination of MRI and MRS yields superior diagnostic results than either modality alone. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
PURPOSE: To investigate the feasibility and diagnostic value of a whole prostate qualitative approach to combined magnetic resonance imaging and spectroscopy (MRI+MRS) in the detection of prostate cancer in patients with elevated PSA. MATERIALS AND METHODS: Three hundred and fifty six subjects (mean serum PSA 11.47ng/ml, range 0.40-133ng/ml) were examined with fast-T2-weighted images (MRI) and 3D-magnetic resonance spectroscopy (MRS). Both modalities were qualitatively analyzed on a whole prostate basis by a single radiologist using a 4-point diagnostic scale. Prostate cancer was histopathologically proven in 220 patients and non-evidence of cancer was determined after at least 12 months clinical follow-up in 136 subjects. RESULTS: Receiver operating curve analysis revealed a significantly better diagnostic performance of MRI+MRS (A(z)=0.857) than MRI alone (A(z)=0.801) and MRS alone (A(z)=0.810). The sensitivity, specificity and accuracy of MRI+MRS for detection of prostate cancer were 72.3%, 92.6%, and 80.1%, respectively. CONCLUSIONS: Spectral evaluation with a whole prostate qualitative approach is feasible in routine clinical practice. The combination of MRI and MRS yields superior diagnostic results than either modality alone. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
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